In Copyright Since September 11,
2000This
web site is
in no manner
affiliated with any Kaiser entity and the for profit Permanente.
Permission
is granted to mirror this web site - Please acknowledge where the
material was obtained.Link
for Translation of the Kaiser Papers

Sanctions for doctor predate job
in Oregon
New York records show findings of negligence and incompetence
by Jayant
M. Patel, who now is under investigation in Australia
Friday, April 22, 2005
DON COLBURN and SUSAN GOLDSMITH
The Oregonian

Five years before he
was
hired as a surgeon by Kaiser Permanente in
Portland, Dr. Jayant M. Patel was disciplined by New York state for
negligence,
incompetence and unprofessional conduct.

Patel, who worked
for Kaiser from 1989 to 2001, is at the center of
a major investigation in Australia for allegedly botching surgeries and
falsifying records during a two-year tenure at a public hospital in
Queensland
after he left Portland.

The Australian
inquiry, which also involves a review of patient deaths
at the hospital where Patel was chief surgeon, has focused new
attention
on disciplinary actions against him in both Oregon and New York.

Kaiser restricted
Patel's surgical practice in 1998, and the Oregon
Board of Medical Examiners, citing negligence in at least four cases,
followed
suit in 2000. But the New York disciplinary action shows that Patel's
career
troubles started long before he arrived in Oregon.

In New York, Patel
was fined $5,000 and suspended for six months, records
show. But New York authorities stayed the suspension and put Patel on
probation
for three years beginning in March 1984.

The charges against
Patel in New York involved five patients he treated
in Rochester. Investigators said he entered information in their charts
without examining them and also harassed one of them to hinder a
hospital
investigation of his behavior.

Although the
records were publicly available, Kaiser Permanente did
not check Patel's disciplinary record in New York before hiring him as
a surgeon in 1989.

Patel, 55, received
his medical degree in 1973 in India and in 1977
moved to the United States. He trained as a surgeon in Rochester and
Buffalo,
N.Y., from 1978 to 1984, and worked in Buffalo until 1989.

"When Dr. Patel
applied to work here in 1989, we confirmed he had completed
his medical residency requirements to practice in the United States and
held a valid, unrestricted Oregon medical license," said Jim Gersbach,
a Kaiser spokesman.

He said Kaiser
officials were unaware of Patel's record in New York
record until being contacted Thursday by The Oregonian. Earlier, Kaiser
said Patel had arrived with favorable reviews from prior employers.

Patel also brought
"stellar recommendations," when he applied for an
Oregon medical license in late 1988, said Kathleen Haley, executive
director
of the Oregon Board of Medical Examiners.

Glowing letters
from Patel's supervisors in Rochester and Buffalo carried
more weight for the Oregon board than his earlier probation, Haley
said.
The Oregonian obtained copies of the letters Thursday from the board.

While a surgical
resident in Rochester from 1978 to 1982, Patel showed
"technical and professional brilliance," Dr. J. Raymond Hinshaw, a
prominent
Rochester surgeon wrote the Oregon board in late 1988.

Aware of Patel's
probation in New York, the Oregon board followed up,
asking Hinshaw for more detail about Patel's dismissal from the
University
of Rochester's surgical residency program.

Hinshaw said a
divided review committee had voted 5 to 3 to dismiss
Patel in 1981 after two patients claimed he had added information to
their
medical charts without examining them.

Harassment claimed

But Hinshaw also
described the proceedings against Patel as "harassment
of a brilliant young surgeon" and said he would recommend Patel
"without
reservation."

After his dismissal
from the Rochester residency program, Patel worked
as a research assistant for Hinshaw before moving to Buffalo, where he
completed his surgical training, according to Hinshaw's letter.

Hinshaw, a former
president of the American College of Surgeons and
chairman of the New York Society of Medicine's surgery section, died in
1993.

The chairman of the
microbiology department at the State University
of New York at Buffalo also recommended Patel to the Oregon board in
March
1989. Thomas Flanagan described Patel's strengths as "curiosity,
diligence,
intellect," and rated his judgment "excellent" and his medical
knowledge
"extensive."

Patel joined the
staff of Kaiser Permanente as a general surgeon in
1989. He performed operations at the now-closed Bess Kaiser Hospital in
North Portland, as well as Providence St. Vincent Medical Center.

In 1998, after
reviewing 79 surgical cases by Patel, Kaiser restricted
his practice and alerted the Oregon medical board. Kaiser banned Patel
from certain operations, such as pancreatic and liver surgery, and
required
him to seek a second opinion on all complicated cases.

An Oregon review

The Oregon medical
board conducted its own review of the Kaiser cases,
focusing on four patients, including three who died and a fourth who
lost
gastrointestinal function after Patel performed a colostomy backward.
The
board, citing "gross or repeated acts of negligence," made the Kaiser
restrictions
statewide in 2000 but did not revoke Patel's license.

Patel kept his New
York medical license after moving to Oregon. But
he surrendered it in April 2001, after New York authorities notified
him
that Oregon's disciplinary move could be grounds for revoking his New
York
license. Kaiser's Gersbach has said Patel left that same year but
declined
to discuss circumstances of his departure.

New York's action
against Patel in 1984 was first reported this week
by The Australian newspaper. The charges against Patel involved five
patients,
identified as A through E in the public record. State authorities acted
on the basis of a fact-finding report by a committee of the New York
Board
for Professional Medical Conduct.

The report charged
Patel with entering information into the patients'
medical records without examining the patients themselves. For example,
according to the report, he wrote "lungs clear" into the record of
Patient
B "without personally examining the patient's chest."

The report also
charged Patel with "moral unfitness to practice" medicine
under New York law. It accused him of false reporting, "abandoning or
neglecting
a patient in need of immediate professional care," and "harassing,
abusing
or intimidating a patient either physically or verbally" in an effort
to
"coerce her not to cooperate with an official hospital investigation of
(Patel's) actions."